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"ABSTRAKLatar Belakang. Anak epilepsi dengan usia awitan di atas lima tahun merupakan kelompok dengan karakteristik epidemiologis dan klinis khas yang mungkin memiliki faktor risiko resistensi terhadap obat anti epilepsi OAE spesifik. Penelitian mengenai resistensi obat pada kelompok usia ini masih sedikit. Tujuan. Mengidentifikasi faktor risiko resistensi OAE pada anak epilepsi dengan usia awitan di atas lima tahun. Metode. Dilakukan penelitian kasus kontrol terhadap anak epilepsi dengan usia awitan di atas lima tahun yang berobat di poliklinik RS Cipto Mangunkusumo dan Mohammad Hoesin bulan Agustus-September 2016. Kelompok kasus adalah anak yang resisten OAE sedangkan kelompok kontrol adalah anak responsif OAE berdasarkan klasifikasi ILAE 2010. Faktor risiko yang diteliti yaitu awitan, jumlah kejang dan lama sakit sebelum berobat, etiologi, jenis kejang, status epileptikus, gambaran EEG awal, evolusi EEG, pencitraan otak dan respon awal terapi. Hasil. Sebanyak 32 pasang anak ikut dalam penelitian. Setelah analisis regresi logistik, faktor yang ditemukan berhubungan dengan resistensi OAE adalah etiologi simtomatik adjusted OR 84,71; IK 95 5,18-1359,15 dan respon awal pengobatan tidak baik adjusted OR 72,55; IK 95 7,08-743,85 . Simpulan. Etiologi simtomatik dan respon awal pengobatan tidak baik merupakan faktor risiko resistensi terhadap OAE pada anak epilepsi dengan usia awitan di atas lima tahun yang bersifat independen.

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Background. Epileptic children with onset above five years encompass distinct epidemiological and clinical characteristics that may have specific risk factors for resistance to anti epileptic drugs AED . Studies on this age group are limited. Objective. To identify risk factors for drug resistance in epileptic children with age of onset above five years. Methods. A case control study was conducted on epileptic children with onset above five years visiting Pediatric Neurology clinic of Cipto Mangunkusumo and Mohammad Hoesin Hospital between August and September 2016. Cases consisted of drug resistant children while control consisted of drug responsive children according to 2010 ILAE classification. Risk factors studied include onset, number of seizures and illness duration before treatment, cause, seizure type, status epilepticus, initial EEG and evolution of EEG, brain imaging, and initial treatment response. Results. Thirty two pairs of children were included in the study. After logistic regression analysis, symptomatic etiology and failure to achieve early response to treatment were found to be associated with drug resistance with adjusted OR 84.71 95 CI 5.18 1359.15 and 72.55 95 CI 7.08 743.85 respectively. Conclusion. Poor initial response to AED and symptomatic etiology are independent risk factors for drug resistance in epileptic children with age of onset above five years. "

"Parents of children with autism spectrum disorders (ASDs) are in constant need of information about every aspect of their child's development. Now the task of understanding and managing their child's general health and medical care is made much easier with Healthcare for Children on the Autism Spectrum -- the first book for parents to focus on this important subject. While a child with autism can be as healthy as any other, autism creates challenges, such as sensory issues and communication difficulties, that become a factor when considering almost all healthcare decisions. Dr. Volkmar, a leading authority on autism and director of the Developmental Disabilities Clinic and Research Program at the Yale University Child Study Center, and Dr. Wiesner, a pediatrician with a special interest in the field, offer parents and healthcare providers accessible, comprehensive information on a wide array of medical, nutritional, and behavioral concerns. Parents can find answers to help them understand symptoms and behaviors, guidelines to evaluate medications and alternative therapies, and tips to make doctor and dentist visits more manageable. There is also useful advice on how to forge a strong parent-doctor partnership, which is the cornerstone to any child's good health. This is an essential medical reference for all families, no matter where their child may fall on the autism spectrum"

"Kasus Covid-19 semakin meningkat hingga pada 30 Januari 2020, WHO menetapkan kejadian Covid-19 sebagai Kedaruratan Kesehatan Masyarakat yang Meresahkan Dunia (KMMD). Puskesmas sebagai garda terdepan memiliki peran penting dalam memutus rantai penularan Covid-19. Bahkan, sampai 22 Juni 2021 sebanyak 23,8% kasus terkonfirmasi berada di Provinsi DKI Jakarta dan 6.393 jiwa berada di wilayah Puskesmas Kecamatan Pademangan. Selain menangani kasus Covid-19, Puskesmas tentunya tidak meninggalkan pelayanan yang menjadi fungsi Puskesmas salah satunya pelayanan Kesehatan Ibu dan Anak (KIA). Dalam menyiapkan generasi masa depan, pelayanan KIA sangat diprioritaskan di masa pandemi Covid-19 ini. Penelitian ini bertujuan untuk menganalisis dampak pandemi Covid-19 terhadap pelayanan KIA di PKC Pademangan. Penelitian kualitatif dengan desain rapid assessment prosedur ini menggunakan data primer yang berasal dari wawancara mendalam dan data sekunder yang berasal dari telaah dokumen. Hasil penelitian menunjukkan adanya perbedaan baik dari komponen input (SDM kesehatan, anggaran, sarana prasarana), proses (perencanaan, pengorganisasian, pelaksanaan, pengawasan), dan output (capaian kinerja) pada sebelum dan selama pandemi Covid-19. Pada komponen input, perbedaan utama terletak pada refokusing anggaran sehingga anggaran pelayanan KIA berkurang dari tahun sebelumnya, serta dibukanya Ruang Bersalin yang menjadikan SDM Kesehatan di KIA terbagi untuk pelayanan RB. Pada komponen proses, metode perencanaan menjadi daring serta meminimalisir kegiatan outdoor dan sesuai protokol kesehatan. Pandemi Covid-19 menjadikan adanya tim tersendiri untuk rujukan dan penanganan Covid-19. Pada komponen output, sebagian besar capaian bulanan di tahun 2020 lebih rendah daripada tahun 2019. Puskesmas sebagai pembinaan wilayah dapat merangkul aparat daerah, masyarakat, dan fasilitas kesehatan yang berada di wilayah Kecamatan Pademangan, serta meningkatkan peran keluarga dalam mendukung ibu hamil dengan memberikan pendidikan kesehatan agar semakin banyak ibu yang termotivasi dan sadar akan pentingnya melakukan pemeriksaan KIA secara teratur.

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As the increasing of the covid-19 case by January 30, 2020, WHO makes the final decision that covid 19 as the Public Health Emergency of International Concern (PHEIC). Puskesmas as the frontline healthcare system have an important role to cut the spread of this virus. According to the data, by June 22, 2021, 23% of cases have been confirmed in DKI Jakarta province and 6.393 people have been infected in Puskesmas Pademangan district. Besides dealing with the covid case, Puskesmas has its function to provide healthcare for mothers and babies (Maternal and Child Health). Preparing the future generation, healthcare for mothers and babies is prioritized during the covid 19 pandemics. This research aims to analyze the covid 19 impacts on the Maternal and Child Health in Puskesmas Pademangan district. This is qualitative research that uses a design of rapid assessment procedure with primary data of inclusive interview and secondary data from the documents that have been analyzed. The result of this research shows that there are distinctions from the input component (human resources, budgets, facilities), process (planning, organizing, implementing, controlling), and output (target working) before and during the covid pandemic. In the input component, there is the main distinction in refocusing the cost budget as the result the budget for Maternal and Child Health has been reduced from the previous year, they also provide delivery rooms that cause the healthcare workers has been split up for dealing the patients in delivery rooms. In-process component, planning method becomes a non-face to face to minimize the outdoor activity and to follow health protocol. Covid 19 pandemic causes puskesmas to make a particular team (a coordinating team) and a treatment team or a team who handles or gives treatment. In the output component, most of the monthly work target in 2020 is lower than in the year 2019. Puskesmas as a local health organization need to cooperate and engage with the government district, society, and provider of health facilities in Pademangan district, also increase the role of families in supporting pregnant mothers by giving health education to motivate and make them aware of how important to do a pregnancy consultation regularly. "